Prescriber Eligibility
Real Time Web Queries to the HMS Provider Master File for Current License, DEA and Sanctions Status
The Federal Health Information Technology Strategy for Privacy and Security requires that HIEs/HIOs improve privacy and security protections for health information and prevent unauthorized or inappropriate access.
Providers have 2 identities—a personal identity and a professional identity. Both should be authenticated prior to giving the provider access to PHI. This requires access to primary sourced information from state license boards, the DEA and the OIG.
Our Health Information Exchange Solutions and Services:
- Help to prevent inappropriate access to PHI by providers with questionable credentials
- Can be easily incorporated into an HIE Privacy and Security infrastructure framework
- Provide a one-stop-shop for primary sourced provider information
- Enable real-time access to the HMS Provider Master File master provider index
- Facilitate provider enrollment process for Health Information Exchanges.
The HMS Provider MasterFile is a national Master Provider Index which aggregates information about 5.1 million healthcare providers from more than 2,000 sources and crosswalks all of this data to create a provider “golden record.”
HMS enhances privacy and security safeguards
Provider Directories for Initial Provider Enrollment
- Pre-populate Health Information Exchange (HIE) provider directories with comprehensive provider profiles from the national HMS Provider Master File master provider index
- Information includes: professional identifiers, demographics, affiliations, sanctions
- License provider profiles by region, state or nationally
Provider Professional Identity Authentication
- Secret questions about providers automatically generated from HMS Provider Master File provider profiles upon web service xml requests
Provider Professional Credentials Verification
- Web service check of provider’s license and DEA status at the time of request to view protected health information
- Web service check of provider’s sanctions across all 50 states at the time of request to view protected health information
We help HIEs comply with HIPAA privacy and security requirements.
Our Health Information Exchange Provider Verification Solutions:
- Are easily incorporated into a service oriented architecture (SOA)
- Enable HIEs to implement the ONC HIT Policy Committee’s recommendation to verify a provider’s identity
- Give HIEs immediate access to the primary sourced national HMS Provider Master File so they can overcome “fabric of trust” limitations as the HIE expands its geographic coverage across unfamiliar new medical trading areas, states and eventually nationally